Case Study: Top Five Healthcare Payer Organization achieves automated 834 reconciliation and reduced administrative costs with Infogix

Automating Reconciliation of 834 Membership & Enrollment Data

A top-five U.S. healthcare payer serving more than 10 million members was struggling with missing and inaccurate 834 membership and enrollment data entering through its EDI gateway. Reconciliation across the gateway, editing system and proprietary membership system was manual, time-consuming and risked incorrect policyholder records and compliance gaps.

Infogix Professional Services deployed the Infogix Enterprise Data Analysis Platform to provide end-to-end visibility, automated validations (member balancing across interfaces and 999 acknowledgements), real-time exception reporting and a full audit trail. The solution automated reconciliation, sped anomaly resolution, reduced administrative costs and delivered more reliable policyholder data.